肠造口患者经济毒性的潜在剖面分析及影响因素

doi:10.6040/j.issn.1671-7554.0.2025.0573

摘要/Abstract

摘要： 目的基于潜在剖面分析探索肠造口患者经济毒性的潜在类别,分析其影响因素,为制订针对性干预策略提供依据。方法采用便利抽样法,于2023年4月—9月选取天津市某三级甲等医院肠造口门诊的512例患者为研究对象。采用一般资料调查表、家庭关怀度指数量表、癌症患者报告结局的经济毒性量表和慢性病治疗功能评估-灵性健康量表进行调查。采用Mplus 8.3进行潜在剖面分析,采用SPSS 21.0进行多项logistic回归分析影响因素。结果肠造口患者经济毒性可分为3个潜在剖面:无经济毒性组(17.19%)、轻度经济毒性组(47.27%)和中度经济毒性组(35.54%)。多项logistic回归分析显示,家庭关怀度较低、灵性健康水平较低、文化程度较低、医疗费用支付方式为城镇居民医保或农村合作医疗,以及家庭人均月收入处于1 001~3 000元区间,是患者归入更高经济毒性组的独立影响因素(P<0.05)。结论肠造口患者经济毒性存在明显的群体异质性,受客观经济条件与主观心理社会资源的共同影响。医护人员应依据不同剖面的特征实施分层管理,构建整合医疗、心理与家庭支持的综合干预模式,以精准缓解患者的经济毒性。

关键词: 结直肠癌, 造口, 经济毒性, 家庭关怀度, 灵性健康, 潜在剖面分析

Abstract: Objective To explore the potential categories of financial toxicity in patients with enterostomy using latent profile analysis(LPA)and to analyze their influencing factors, aiming to provide a basis for developing targeted intervention strategies. Methods From April to September 2023, a total of 512 patients from the enterostomy clinic of a Grade A tertiary hospital in Tianjin were selected by convenience sampling. Data were collected using a general information questionnaire, the Family APGAR index, the Comprehensive score for Financial toxicity-functional assessment of chronic illness therapy, and the Functional assessment of chronic illness therapy-spiritual well-being scale. Latent profile analysis was performed using Mplus 8.3, and multivariate logistic regression analysis was conducted using SPSS 21.0 to identify influencing factors. Results The financial toxicity of enterostomy patients could be classified into three latent profiles: the non-financial toxicity group(17.19%), the mild financial toxicity group(47.27%), and the moderate financial toxicity group(35.54%). Multivariate logistic regression analysis revealed that lower family care, lower spiritual well-being, lower educational level, medical payment methods of urban resident medical insurance or new rural cooperative medical care, and a per capita monthly household income in the range of 1,001-3,000 yuan were independent factors influencing patients classification into higher financial toxicity profiles(P<0.05). Conclusion There is significant heterogeneity in financial toxicity among enterostomy patients, influenced by both objective economic conditions and subjective psychosocial resources. Healthcare professionals should implement stratified management based on the characteristics of different profiles and construct a comprehensive intervention model integrating medical, psychological, and family support to precisely alleviate patients financial toxicity.

Key words: Colorectal cancer, Enterostomy, Financial toxicity, Family care, Spiritual health, Latent profile analysis

中图分类号:

R735.3

王竞,闫奕杉,肖露露,汪子玲,刘亚红,刘锐,晁群. 肠造口患者经济毒性的潜在剖面分析及影响因素[J]. 山东大学学报 (医学版), 2026, 64(6): 77-85.

WANG Jing, YAN Yishan, XIAO Lulu, WANG Ziling, LIU Yahong, LIU Rui, CHAO Qun. Latent profile analysis of financial toxicity and its influencing factors in patients with enterostomy[J]. Journal of Shandong University (Health Sciences), 2026, 64(6): 77-85.

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